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PATIENT CENTERED MEDICAL HOME<br />Definition<br /><ul><li> Medical home, also known as Patient-Centered Medical Home (PCMH), is defined as "an approach to providing comprehensive care that facilitates partnerships between individual patients and their personal providers and when appropriate, the patient’s family”</li></li></ul><li>PATIENT CENTERED MEDICAL HOME<br />History<br /><ul><li> American Academy of Pediatrics introduced the term in 1967

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Provides for all the patient’s health care needs</li></ul> or <br /><ul><li>Takes responsibility for appropriately arranging care with other qualified professionals</li></ul>Includes care for all stages of life<br /><ul><li>acute care

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Practices go through a voluntary recognition process by an appropriate non-governmental entity to demonstrate that they have the capabilities to provide patient centered services consistent with the medical home model.

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Investment in primary care of $16 per patient per year was associated with a savings of $17 per patient per year</li></li></ul><li>The Quadruple Aim<br />Enabling a medically ready force, a ready medical force, and resiliency of all MHS personnel.<br />Experience of Care<br />Population Health<br />Patient and family centered care that is seamless and integrated. Providing patients the care they need , exactly when and where they need it. <br />Readiness<br />Improving quality and health outcomes for a defined population. Advocating and incentivizing healthy behaviors. <br />Per Capita Cost<br />Managing the cost of providing care for the population. Eliminate waste and reduce unwarranted variation; reward outcomes, not outputs. <br />25<br />

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Army PCMH Model<br />PCMH ratios. <br />2 exam rooms per PCM<br />3.1 support staff <br />direct staff who work for a single PCM<br />shared staff who work among several PCMs in the PCMH Team<br />< two exam rooms per PCM, the enrollment cap will be reduced accordingly<br />

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17 Clinics in 11 Markets -- Beginning in Fall of 2010<br />Army Community Based Medical Homes<br />The Army is Investing inHealthcare Capacity<br /><ul><li> Improve the readiness of our Army & our Army Family

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Payment appropriately recognizes the added value</li></li></ul><li>PATIENT CENTERED MEDICAL HOME<br />Communication of care<br /> One of the best benefits of implementation of the Patient Centered Medical Home is the establishment of standard work. Everyone has an expected role and a way to document. Before the PCMH, reviewing the medical record was like dumpster diving for data<br /><ul><li>Group Health Provider</li></li></ul><li>How Do We Integrate Care?<br />60<br />

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New Patient To Your Clinic<br />36 year Old female<br />How do you learn of this patient?<br />How should you learn of this patient?<br />In a PCMH Clinic what should you do when you learn of your new patient?<br />70<br />

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Put It All Together(shared decision making)<br />Individualized Comprehensive Care Plan (CCP)<br />Pt satisfied with SAR tx if she can stop sneezing and itchy eye and not feel tired from any medication (has a job and kids)<br />Pt has been thinking about quitting smoking but too much stress right now (contemplative stage with barriers)<br />Willing to stop her OCP to reduce stroke risk since husband is deployed anyway<br />Willing to see someone about her anxiety but doesn’t want to start any medication that will “knock her out or get her addicted”<br />Wants help with her “hyper child” causing her a lot of stress and she gets very frustrated with him.<br />She has tried to lose weight many times and will be stressful right now to lose all the weight needed to get to BMI of 25 but willing to work with team to achieve 10% weight loss to reduce risk of medical complications <br />75<br />